Outside In: A program designed by a San Francisco resident experiencing homelessness

Seth1, a San Francisco resident who had been living on the street for four years, remembers the moment when he decided to enter a substance use treatment program. He was sitting in a doorway in the South of Market neighborhood at 7 in the morning. He was holding a bottle of vodka, and it was raining.

“This guy across the street from me walked out with a dog,” he said. “The dog was happy and jumping around. I realized: That f*cking dog has it better than I do. It lives inside—I don’t. It has a coat—and I don’t. It sleeps in a bed—I don’t. It eats every day—I don’t. I want to start living as good as a dog.”

Seth ended up without housing after breaking off a “crazy, drug-fueled relationship” with a partner of 11 years. He decided their destructive relationship had to end—even if it meant he would lose his stable housing. During his relationship, and then when he was living on the street, Seth used crystal meth, PCP and GHB. There were “numerous” stints in jail, and more than a handful of trips to the hospital. “All because of the drugs I was taking,” he said.

Seth was introduced to the Stonewall Project, the substance use program of San Francisco AIDS Foundation, through a 90-day program at a residential treatment service agency. The Stonewall Project provides a structured counseling program in addition to a variety of social support and drop-in group opportunities.

He remembers meeting Audra, a San Francisco AIDS Foundation staff member, for the first time. It was a pivotal—and emotional—moment.

“I went up to the desk and she asked me my name. And, she remembered my name so that every time I came back, she would say, ‘Seth, how are you?’ Sometimes it was shocking, to hear my name out loud. When you’re homeless, you become invisible. Nobody knows your name. When people see a homeless person, they look the other way. They put their headphones on, or they start looking at their phone. That’s how you become invisible. With Audra, I became un-invisible. That’s why it was so emotional for me.”

Seth named other San Francisco AIDS Foundation staff who were a critical part of what he calls his recovery. He said that Terry Morris and Pauli Gray, who are part of Syringe Access Services, “would look me straight in the eye when they talked to me. I would become the most important person in the world.” Christopher Powers, a substance use counselor for the Stonewall Project, helped Seth navigate the many challenges associated with unstable housing and abstaining from substance use.

With Powers, Seth designed a drop-in group that the foundation now hosts. Called “Outside In,” the group addresses the difficult situations that people who are experiencing homelessness, or who have unstable housing, face as they work on changing their relationship to substances.

“We address practical issues around surviving while homeless as well as all of the emotional and psychological fallout associated with homelessness and with becoming housed after having been homeless,” said Powers, who leads the group with Peter Carnini, another counselor, once a week.

“It all began one day when I came into therapy and I was on fire,” said Seth. “I said, ‘I need to talk to other people who are having these same kinds of issues. I need a group where we can talk about navigating GA [General Assistance]. And how people navigate living in an SRO [single room occupancy hotel] and not getting high. And having your sh*t broken in to. And not having any place to be. And how to get into treatment.’ He [Powers] said, ‘This is great,’ and started writing it down. And now these are the topics we talk about in Outside In.”

The group begins at 9:30 in the morning—a time that fits into the schedule of a person who may be relying on shelters and meal programs.

“They kick you out of shelters at 7:30 or 8 in the morning,” explained Seth. “I’d go to Glide, to have breakfast, and then I’m done by 9 am, and don’t have anywhere to be until noon. There’s this down time between 9:30 and noon. We need a place to be so we’re not out there getting high. [The group] fills the gap. We can have donuts and coffee, and it fits into the ‘homeless schedule.’”

Now, Seth is living in a house with other people who do not use substances. He’s doing well, he says, and still attends groups and services. In October, Seth will participate in a Stonewall Project graduation ceremony, where he will mark and celebrate two years of sobriety.

He’s also found a way to give back to people who are experiencing homelessness, as a board of directors member and regular volunteer for The Burrito Project, a community group that makes and distributes vegan burritos to people living on the street once a month.

“I’ve gone from homeless to feeding the homeless, which is a pretty cool thing,” he said.

In June of 2017, the Outside In group celebrated its two-year anniversary.

“It has been very well attended ever since [the group began],” said Powers. It’s nice to be able to provide a place for our participants to get some support around homelessness and related issues especially during the current housing climate in San Francisco which has made it harder and harder to get and keep housing.”

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Are you interested in making changes to how you manage drugs and/or alcohol in your life? Visit The Stonewall Project online or call 415-487-3100 to learn how to connect to services.

Outside In is a walk-in discussion group that explores the challenges, successes, emotions and general experience of gay/bi/heteroflexible men who have been at times homeless and at other times house. The group meet every Friday morning, from 9:30 am – 11 am in room 2C at 1035 Market Street, Suite 400 in San Francisco.

We believe that San Francisco can be the first U.S. city to end the HIV epidemic. Every day, we provide free prevention and care services to people in hard-hit neighborhoods—and advocate for them to public officials—because we can envision the day when we beat HIV.

San Francisco AIDS Foundation is a California nonprofit public benefit corporation which has been granted tax exempt status under Internal Revenue Code section 501(c)(3). Our Federal EIN is 94-2927405 and our California corporation number is C1241510.